Ped eyes, skin, rash Flashcards
Define Strabismus?
Anomoly of ocular alignment
Strabismus one or both eyes?
Unilateral or bilateral
Eso vs Exo in Strabismus?
Eso=nasal deviation
Exo=temporal deviation
Phoria vs Tropia in Strabismus?
Phoria=latent
Tropia=Manifest
Hering Law in Strabismus?
Muscles in both eyes receive equal innveration. “Two eye law”.
Sherrington’s law in Strabismus?
Reciporcal innervation. “One eye law”
Dx of Strabismus?
H + P
Tx of Strabismus?
GLasses with and w/o prisms, mitotic drops, patching, visual training, surgery to reposition or shorten. Refer to optho.
Impetigo in what age range?
2-5y/o
MC of Impetigo?
S Aureus
Primary Impetigo?
Direct invasion of normal skin
Secondary Impetigo?
Infextion d/t trauma of skin
Which most common form of Impetigo?
Non-Bullous
3 forms of Impetigo?
- Non-bullous
- Bullous
- Ecthyma
Non-Bullous Impetigo has what appearance?
honey-colored
Where does Non-bullous Impetigo occur?
Faces and extremities
Systemic sx with Non-bullous Impetigo?
No
Bullous Impetigo in what age range?
younger kids
Bullous Impetig cyst color?
Clear yellow fluid which becomes brown
Bullous Impetigo toxin?
S Aureus Toxin A
Least common form of Impetigo?
Echyma
What sort of ulcers in Ecthyma Impetigo?
Punch Out ulcers with yellow crust
Dx of Impetigo?
H+P. Can culture fluid or at base of lesion if tx fails.
Topical tx of Impetigo?
If limited number of lesions.
Mupirocin (Bactroban), H2O2 cream
PO tx of Impetigo when?
If bullae or multile lesions in many locations. Diclox, cephalexin, clinda. Bactrim if MRSA.
Pinworn aka?
Enterobiasis
Etiology of Pinworn?
Enterobilus verminocolanis
Transmission of Pinworn? Carried where?
Fecal-oral route. FIngernails, beddins, dust, clothing
Describe Pinworm. Where are they?
<1cm, white, threadlike. Visible worms around arms and butt.
Where Pinworm inhabit?
Cecum, appendix, ileum, ascending colon
Pinworn itching when and where?
Nocturnal perianal and perineal itching
Dx of Pinworn?
Hx of nocturnal itch. Collect with cellophane tape or pinworm paddle. Inspect stool or anus. Repeat inspection.
Tx of Pinworn?
Albendazole (Albenza) 400mg once. Repeat in 2 weeks.
OTC=Pyrantel Panmoate
Erythema Infectiosum aka?
Fifth’s Disease
Eti of Erythema Infectiosum?
Parvovirus B19
Incubation period of Erythema Infectiosum?
1-2 weeks before sx
Day 1-2 of Erythema Infectiosum?
Fever, HA, nausea, vomiting
Day 2-5 of Erythema Infectiosum?
Rash, “slapped cheeks”. Reappear with sunlight, heat changes, exercise, stress.
Dx of Erythema Infectiosum?
H+P
Tx of Erythema Infectiosum?
Supportive only. No meds.
What really bad thing can Parvovirus B19 also cause?
Fetal Hydrops (Fetal demise)
Transmission of Infectious Mono?
Salivary secretions
Incubation of Infectious Mono?
4-7 weeks
Sx of Infectious Mono?
Fever, fatigue, pharyngitis, erythema, petechiae, splenomegaly, posterior cervical adenopathy, self-limiting hepatitis
Infectious Mono common after use of what abx?
PCN/AMP
Dx of Infectious Mono?
H+P. Monospot Heterophile Ab.
Tx of Infectious Mono?
Supportive. Steroids is tonsils block airway.
Antivirals in Infectious Mono?
NO
Careful for how long after Infectious Mono?
3-4 weeks until spleen gets better
Measels aka?
Rubeola
Etiology of Measels?
Morbilliform virus
Incubation of Measels?
7-21d
Droplets and contagious in Measels?
Airbone and droplets on surface up to 2h. Highly contagious. Contarious 4d before and 4d after rash.
What spots are pathognomic in Measels?
Koplik spots
Rash in Measels?
Head to toe maculopapular rash
Dx of Measels?
H+P
Tx of Measels?
Mostly supportive
PPX of Measels?
MMR vaccine within 72h of exposure. IG if w/n 6d of exposure.
Tx of severe Measels?
Vitamin A
Rubella aka
German Measels
Transmit of Rubella?
Airborne transmission
How long sx of Rubella last?
2-3 days
Sx of Rubella?
Rash, low grade fever
Rubella causes what in preggers women?
Birth defects
Roseola aka
Exanthema Subitum, 6th disease
Etiology of Roseola?
HHV-6/HHV-7
Age of Roseola?
90% >2y
Roseola and vertical transmission?
Can happen
Roseola fever onset and degree?
Sudden high fever 102-104
After fever in Roseola what happens next?
ASx rash appears on trunk, arms, legs
Kawasaki Dz aka
Mucocutaneous Lymph Node Syndrome
What is MC cause of childhood vasculitis?
Kawasaki Dz
What age and ethnicity gets Kawasaki Dz?
<5 y/o, Asian
Etiology of Kawasaki Dz?
Unknown
Kawasaki Dz affects which vessels and which major organ?
Widespread inflammation of medium size vessels and heart
Lips and tongue in Kawasaki Dz?
Cracked red lips, strawberry tongue
Which lymph nodes enlarged in Kawasaki Dz?
Anterior cervical >1.5cm
Tachycardia and fever in Kawasaki Dz?
Tachycardia out of proportion to fever
Heart sounds and Kawasaki Dz?
muffled heart sounds
Dx of Kawasaki Dz?
Clinical H+P
Heart tests in Kawasaki Dz?
Cardiac echo to detect aneurysm every 4-6 weeks
Which tx dramatically reduces risk of cardiac aneurysm in Kawasaki Dz?
IVIG
If give IVIG in Kawasaki Dz what about vaccines?
No live vaccines for 11 months
Tx of inflammation in Kawasaki Dz?
ASA 81-100mg q6h x14d
First Dz aka
Measels
Second Dz aka
Scarlet Fever from strep
Third dz aka
Rubella
Fourth Dz aka
?staph?
Fifth Dz aka
Erythema Infectiosum Parvovirus B19
Sixth dz aka
Roseola HHV-6 and 7